Sleep-disordered Breathing in Neuromuscular Disease.

Patients with neuromuscular disorders involving respiratory muscles (upper airway muscles, respiratory accessory muscles, diaphragm, even abdominal muscles that stabilize the chest) have more significant problems with breathing during sleep, especially during REM sleep, than during wakefulness. There are means of appropriately treating sleep disordered breathing and improving the quality of life of these patients. Treatment helps to avoid daytime symptoms and additional autonomic nervous system dysfunction. The treatment involves support of breathing during sleep. It must be adjusted to the severity of the problem during sleep, which implies systematic investigation and treatment based on polygraphic recordings during sleep. Patients, even when stable, need to be monitored during sleep at least once a year and more often if symptomatic, ie, appearance of any daytime symptom or frequent upper respiratory infection or indication of daytime CO(2) retention.